The Longest Week of My Life: Part Two

On day four I returned to Duke hospital early in the morning for my angiogram. Dr. Alexander was doing this procedure, a catheterization with contrast dye, to get a more detailed "map" of my cranial circulation. It was a short procedure and while I was in recovery they checked me in for the long haul. I was transferred up to my room as soon as I was ready and started the long wait.

If I haven't given the impression, my neurosurgeon, Dr. Michael Alexander, was absolutely fantastic. A little while after I was in my room he came up and talked to my family and me about the procedure that we were expecting the next day. Clipping is an intracranial procedure, which means that I would be shaved and a piece of my skull would be removed, so Dr. Alexander could place a small clip at the base of the bulge to prevent blood from filling it further. It would take between three and five hours to complete the procedure and would happen the following day because the size of my aneurysm was of some concern of rupturing. Of course I was scared by this point (which is a contributing factor about why my memories are so fuzzy) because it was such an invasive procedure. He told me that with the map from the angiogram, he felt very confident in executing the procedure, so I had little doubt that he would do a good job. But of course there were great risks... there always are.

My sister was excited. Not about the procedure, but because she wanted to shave my head for the operation. That's what sisters are for, right?

But before that, the order of the day was more tests to get everything ready for the clipping. Blood tests. CT scan. I had to stop eating twelve hours before the procedure, as with any procedure of this caliber. It was a lot of being shuffled around and prodded. And a lot of waiting. I remember watching a lot of t.v. to get my mind off of things. Television programs that I could dissect for good and bad edit sequences and camera angles. This was the device, the deus ex machina in my story, that brought me to this place.

At about 9 pm, after test after test, a nurse comes in to give me some pre-op medication... an anti seizure drug through my IV since intracranial surgeries are more prone for seizure. It was for my protection. Up to this point I could tell you that the only things I was allergic to were pollen, dander, pine nuts, and dust mites. I don't remember the name of the drug (fuzzy memories strike again), but I remember my skin feeling like it was crawling with a thousand millipedes. Every piece of me itched so badly during the injection that I was standing on my hospital bed getting everyone in the room to help me scratch. I was in agony. So, taking pity on me, she checks with the doctor if I can be cleared for benadryl. YES! So alternating injections, I have anti seizure and benadryl in my system. When both were done, so was I. I slept hard and fast and before I knew it, the morning of surgery arrived.

Day five begins. By this time, everyone was by my side. My family, my boyfriend, and all of his family were by my bedside. I was so grateful everyone was here and as the orderly wheeled me down to the OR, I was tearfully saying my goodbyes. I was clasping hands, not wanting to let go. Because, for as confident I was in the precision of my surgeon's hands and skills, I knew these were my final goodbyes to my loved ones, because if I went in that OR, I wasn't coming out. Yes, my fear level was off the charts. And at the nth hour, a nurse comes through the OR door and tells the orderly to take me back to my room.

WHAT???

I just said my goodbyes. I was ready to meet my life's author. And I was denied entrance to the OR. A couple hours later (and let me tell you, by then, my hunger was extreme!) Dr. Alexander arrives and tells us what happened. The good doctor had ordered an extra test than usual, the CT scan, which revealed that because of my unique plumbing, removing the piece of my skull would have certainly nicked a vein and I would have died on the operating table. He hadn't been quite that graphic, but that was the message. So, I had been saying my final goodbyes, but that angel of a nurse saved me. So now what?

Dr. Alexander explained there was another surgical option that I was a candidate for. Endovascular coiling was a relatively new procedure that takes two to four hours where a catheter is run through the femoral artery to the site of the aneurysm. (Much like the angiogram I had the day before.) Once there, a thin platinum wire is coiled into the aneurysm, filling it, reducing the blood flow within, and promoting clotting around the wire. Because of my circulatory system issues, this was now my only option. I didn't like the word "new,"when this procedure was being described, but I understood it as a last chance before the estimated six month deadline. Sign me up. Again. 

And for goodness sake, take the razor out of the twitchy fingers of my older sister! I would not have to have a hair on my head touched, or a visible battle scar from an intracranial procedure. I could be happy about that.

The new procedure had to wait for a vacant spot in the OR... after lunch. I was starving when I was taken down to the OR, but otherwise feeling good. What were tearful goodbyes that morning were now warm see you laters. We were all joking and keeping good spirits, to the delight of the hospital staff. I can say that my family defies traditionalism and usually rely on humor when others would distress and worry. (That's not saying that the worry wasn't there.) I went into the OR and got all set on the table for the coiling. As I was drifting under from the anesthesia, the Latin beats of Sade crooning lyrics of "Smooth Operator" made me confident that I was in good hands.

I woke up in recovery in agony. When all other memories are fuzzy, this one remains clear. I woke, screaming from pain because two nurses were taking turns applying extreme pressure to my groin, the entry point for the coiling catheter. I wasn't clotting properly and they wouldn't ease up until I did. (Now they inject a collagen plug to mend the entry site.) Finally, my blood clotted and they eased back, keeping a wary eye on me. A very satisfied Dr. Alexander told me the procedure was a success and although I would have a slight headache, I would recover nicely. The only problem was getting the femoral artery to mend properly and stop bleeding. So I went back to my room after I'd stabilized and was kept overnight for observation and recovery.

On the sixth day I woke in the hospital, after poking and prodding from the nurses all night, to orders that I was being released later that day after being briefed on how to care for my headache, keeping my incision site clean and bandaged, and general limitations on my activities during the recovery process. I was scheduled to follow up with Dr. Alexander in a week and have an MRA shortly after, to be scheduled later, to determine the success of the procedure. I was rolled out of Duke Hospital on December 23, 2003, a new person with my whole life stretched before me. 

With platinum in my head after a week filled with strife, I could now live a long happy life.

But stay tuned for more!